Australia needs a colonoscopy wait-time guarantee

Did you know that 1-in-3 people are waiting more than 6 months to learn if they have bowel cancer following a positive screening result?

It is unacceptable that people with a positive screen or bowel cancer symptoms have to wait six months or longer for a colonoscopy to learn if they have cancer.

That is why Bowel Cancer Australia is calling on Federal, State and Territory Governments to commit to a national Colonoscopy Wait-time and Performance Guarantee – with recording, reporting and resourcing – to address delays in diagnosing Australia’s second biggest cancer killer.

During a colonoscopy, pre-cancerous polyps can be detected and removed before they develop into something more sinister requiring surgery and treatment.

If bowel cancer is detected, and it is still in the earliest stages, 90 percent of cases can be successfully treated.

Bowel Cancer Australia has long advocated for referral to colonoscopy within 30 days to minimise patient stress and anxiety, as recommended in the Optimal Care Pathway for people with bowel cancer.

Newly released medical guidelines, however are now recommending patients be referred to colonoscopy within a 120-day threshold. Despite extending the recommended timeline-to-diagnosis by 300%, the new timeframes are still not being met.

Bowel Cancer Australia shares concern expressed by individuals involved in developing the new guidelines, that the extended threshold de-emphasises the need for prompt evaluation.

Research shows diagnostic intervals exceeding 120 days are associated with poorer outcomes, yet 90% of National Bowel Cancer Screening Program (NBCSP) participants with a positive screen are waiting between 116-181 days.

At Bowel Cancer Australia, we believe what is needed is a Colonoscopy Wait-time Guarantee, complete with public wait time recording, reporting and adequate resourcing of colonoscopy.

Publishing wait times will highlight where resources need to be allocated to improve patient care and will demonstrate a clear commitment on the part of government to meet their own endorsed colonoscopy wait-time recommendations.

The proposed Colonoscopy Wait-time and Performance Guarantee should include a maximum wait time of 120 days from first healthcare presentation to diagnostic colonoscopy for people experiencing symptoms suggestive of bowel cancer or a positive screen and public reporting of colonoscopy wait-times by all public and private healthcare facilities, released quarterly.

There should also be adequate funding for diagnostic colonoscopy services across Australia and the collection of patient reported experience measures within 30 days via a questionnaire from all people who undergo a colonoscopy.

This survey would ask them about their pre-procedure experience (whether people understood the risks/benefits), the hospital experience (the procedure itself, issues of dignity/privacy); and post-procedure complications (bleeding/pain) and the results should be publicly reported.

We advocate minimum quality standards and key performance indicators (KPIs) for the delivery of colonoscopy within Australia, along with recording and public reporting of performance against the standards and KPIs.

The National Healthcare Agreement
The National Healthcare Agreement affirms all governments agree that Australia’s health system should, among other things, provide every Australian with timely access to quality health services based on their need, not their ability to pay, regardless of where in Australia they live.

In the lead up to September 2018, the Council of Australian Governments (COAG) is considering a longer-term public hospital funding agreement.

The Agreement will establish a list of commitments which includes public hospital funding, as well as public and private hospital-performance reporting.

The new Agreement will commence on 1 July 2020 – the same year that full implementation of the National Bowel Cancer Screening Program is expected and demand for colonoscopies is projected to reach 1.11 million.

Over the next four weeks, Bowel Cancer Australia is encouraging people to petition the House of Representatives to ensure Australians with bowel cancer symptoms or a positive screen, receive a diagnostic colonoscopy with a maximum wait time of 120 days, no matter where in Australia they live.

People with a positive screen and those with bowel cancer symptoms need assurance that they will receive a diagnostic colonoscopy within no more than 120 days.

Timely access to a diagnostic colonoscopy is essential to reduce bowel cancer deaths and minimise distress and anxiety in people experiencing symptoms or those with a positive screen awaiting investigation.

Julien Wiggins is the Chief Executive Officer of Bowel Cancer Australia, the leading community-funded charity dedicated to prevention, early diagnosis, research, quality treatment and the best care for everyone affected by the disease.

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